MELC (IWT-SBO)

last updated 28-06-2016

Monitoring Quality of End-of-Life Care

Domain: Quality indicatorsEuthanasia

Period: 08-2006 to 08-2010

Status:

Archived

Background

The number of people living to an old age is rapidly increasing in Western countries. Furthermore, technological developments in diagnostic techniques and therapeutic possibilities have increased the survival time of the terminally ill. As a consequence, medical decisions to start up different supportive care technologies (e.g. artificial breathing support, artificial administration of fluid and food) imply also more and more decisions with a potential or certain life shortening effect. In recent studies, incidence of medical decisions with a possible life shortening effect have been estimated at about 40% of all deaths, in Flanders as well as in other European countries (NEJM 1996, Lancet 2000, Lancet 2003). This means that in 4 out of 10 deaths in Flanders, and elsewhere in Europe, the dying process of the terminally ill is surrounded with medical technologies, and death of a patient is preceded by at least one end-of-life decision. To start up different supportive care technologies towards the end of life imply also ethical dilemmas for the patient and his family, and for the care providers. Furthermore, although there is a great need to identify the barriers that hamper the delivery of good end-of-life care, it appears also that in the terminally ill, the delivery of end-of-life care and treatment of symptoms has been poorly studied and evaluated. Although mortality is traditionally one of the most reliable health indicators, the quality of end-of-life care is poorly evaluated in Western countries. Therefore, research should develop quality indicators of end-of-life care, as well as systems to monitor the (development of) quality of this care, for the overall society, but also across care settings, as well as across patient populations.

Research Framework.

The development of representative databases and analysis tools (Vertical research axe)

Work package 1 = Study of medical end-of-life decisions, via the Death certificate method with a sample of 6000 deaths (ELD 3).

Work package 2-4 = A permanent three year End-of-life care registration, via Belgian Sentinel Health Network of General Practitioners (SentiMelc).

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About us

The End-of-Life Care Research Group aims to conduct high-quality scientific research in end-of-life care in Belgium and Europe. The research group is spearheaded by a number of experienced researchers and strives to expand expertise in end-of-life care research.